It is common to understand heart attack as one standalone medical event. Many people may imagine an artery getting blocked and somehow the oxygen supply to the heart gets cut off, comparable to a broken circuit.Howe…

It is common to understand heart attack as one standalone medical event. Many people may imagine an artery getting blocked and somehow the oxygen supply to the heart gets cut off, comparable to a broken circuit.However, this is just one of the many clinical manifestations of the condition, and maybe the most popular one, cardiology experts have said.In a landmark shift, the universal definition of heart attack has undergone a change in favour of the not so commonly addressed pathology that often leads to the same cardiac outcome.This is particularly important for women whose atypical cardiac symptoms have remained underrepresented for long, reports have shown.Landmark changeThe universal definition of myocardial infarction (or heart attack) has been developed and published by four major cardiac societies: the European Society of Cardiology (ESC), the American College of Cardiology (ACC), the American Heart Association (AHA) and the World Heart Federation (WHF).The decision was announced in Munich at an annual ceremony of the European Society of Cardiology (ESC).Timely CPR by Bengaluru cop saves 34-yr-old scooterist after collapses due to heart attackUse of numbers in previous definitionMyocardial infarction (MI) or what is commonly called a heart attack happens when there is decreased or complete stop of blow flow to one or more portions of the heart muscle.The previous (2018) definition of a heart attack as collectively described by four major cardiac societies in the world, the condition was classified in form of numbers which read as follows:MI type 1: Heart attack caused by plaque rupture in the artery carrying blood to the heart.MI type 2: Heart attack caused due to an imbalance between oxygen supply and its consumption by the heart tissues. This category includes many sub-types like coronary artery (vessel carrying blood to heart) suddenly tightening up, clot in the blood vessel, tissue tear in the artery, anemia and others.MI type 3: Sudden death caused by myocardial infarction before the damage to the heart could have been assessed.MI type 4 and 5: Heart attack caused by various procedural interventions, for instance, during or after childbirth or a bypass heart surgery.Why it needed to be upgraded?According to a representative of European Society of Cardiology (ESC) Nicholas Mills, the earlier numeric system and a long list of sub-types made it complex for the clinicians to diagnose it while pinpointing a specific cause and also led to treatment inconsistencies.Hence, there was a need for more simplification in how the medical community should see or predict heart attack and at the same time not understate the sub clauses.As per some experts, the complicated numbering of types even made it hard for the clinicians to communicate it to the patient.Also, some less common (sub-types) causes of heart attack are predominately more common among women than in men. There has been a real risk of their atypical symptoms either getting dismissed on grounds of not matching with the mainstream category.For instance, this could allow a clinician to overlook other red flags if a woman’s artery shows no obvious blockage. It can make them dismiss pathology like tearing of an arterial tissue which could also cause a heart attack.The revised definitionAs per the latest (2026) universal definition of myocardial infarction, there are three primary categories which a cardiologist must look at while assessing a patient who may be at risk of a heart attack:Primary MI: Heart attack possibility due to some problem with the coronary artery itself be it plaque formation (sticky deposit of calcified fat and immune cells), artery tightening/ spasm (spontaneous coronary artery dissection [SCAD]), spasm or a clot) or tissue tearing.Secondary MI: Heart attack possibility due to an illness causing an imbalance between oxygen input and output in the heart muscles. This can include conditions like fast heartbeat (tachycardia), anemia, hypertension and other causes.Procedure-related MI: This includes heart attacks that may typically happen within 30 days of a surgical procedure like a bypass heart surgery.This careful categorisation clusters pathological causes sharing a common underlying pattern together. For instance, all artery related causes in one group. Newly highlighted formsAs per reports, three less popular and overlooked causes of heart attacks have been brought up in the spotlight. Most of them affect women and are not typically due to artery blockage by cholesterol.Coronary artery spasm: The coronary artery may suddenly suffer a spasm or involuntary tightening due to bodily stress, exercise, chemical imbalance or even emotional stress.Coronary embolism: This may happen when a blood clot or a fat deposit circulates up to the artery and blocks it. Notably, it is different from the stereotypical fat deposition or plaque formation in the artery which is often taken as the ‘signature’ cause of heart attack.Spontaneous coronary artery dissection (SCAD): If a tear happens in the coronary artery, it also can cause a heart attack. This commonly occurs among women during or after pregnancy.These new highlights are promising a good solution for the unintended sex-based bias in diagnosing cardiac disorders.Levels of troponinTroponin is a protein complex found in the muscles of the heart. When the heart suffers a muscular injury of any kind, troponin gets released in the bloodstream.Clinicians in Cardiology often measure this protein to assess if the cardiac tissue is injured to some capacity or not.As per reports, the levels of troponin are naturally less in women than in males. In some cases, the pathologists and clinicians may dismiss the levels as normal when they are not very close to the standard levels (based on physiology of males).The fresh guidelines have also promised to re-establish the threshold of troponin to assess cardiac injury in women.

Source: Deccan Herald